HomeMy WebLinkAboutCOM2021-00043 Change Tenant - COM Permit / Conditions - 6/2/2021 Mason County
Mason County - Division of Community Development
615 W. Alder St. Bldg.8
Shelton, WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
F
1-00043 CHANGEINTENANT
DESCRIPTION: OPEN A HAIR SALON IN A SPACE THAT ISSUED: 06/02/2021
IOUSLY A HAIR SALON
ESS: 11 NE OLD BELFAIR HWY UNIT B BELFAIR EXPIRES: 11/29/2021
PARCEL: 123294200010
APPLICANT: Petrich, Kara OWNER: ADIO I LLC
2790 NE Old Belfair Hwy PO BOX 370
BELFAIR,WA98528 BELFAIR,WA 98528
3602869525
FEES: Paid Due
Change in Tenant Application $156.00 $0.00
Planning Review Fee $240.00 $0.00
Technology Surcharge $3.12 $0.00
Change in Tenant- Minor EH $120.00 $0.00
Plan Review
State Fee-Commercial $25.00 $0.00
IFC Plan Check Fee $78.00 $0.00
Totals : $622.12 $0.00
REQUIRED INSPECTIONS
BLD-Final Inspection
CONDITIONS
Printed by:Corey Bennett on:06/15/2021 03:55 PM
Page 1 of 2
Mason County
Mason County - Division of Community Development
615 W. Alder St. Bldg.8
Shelton, WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
CHANGE IN TENANT COM2021-00043
* OWNER/BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit
revocation. Acknowledgement of such is by signature below. I declare that I am the owner, owners legal representative, or
contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained
permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The
owner or authorized agent represents that the information provided is accurate and grants employees of Mason County
access to the above described property and structure(s)for review and inspection. This permit/application becomes null &
void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of
180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT
APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
* If construction or remodeling is proposed an additional Building Permit and construction documents/drawings may be
required.
* Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries,
Contractor Compliance Division. There are potential risks and monetary liabilities to the homeowner for using an
unregistered contractor. Further information can be obtained at 1-800-647-0982. The person signing this condition is either
the homeowner, agent for the owner or a registered contractor according to WA state law.
* Lever hardware is required at doors. The unlatching of any door shall not require more than ONE operation. Hardware with
locks must open with a single action from the egress side of the door. Door hardware shall allow egress doors to be readily
open able from the egress side without the use of a key or special knowledge or effort. Handles, pulls, latches, locks and
other operable parts on accessible doors shall have a shape that is easy to grasp with one hand and does not require tight-
grasping, pinching, or twisting of the wrist to operate. X
* All building permits shall have a final inspection performed and approved by Mason County Building Department prior to
permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property
records on file with Mason County as being non-compliant with Mason County ordinances and building regulations.
* The use, handling and storage of hazardous materials or flammable and combustible liquids in excess of 10 gallons is not
allowed without the approval of the Mason County Fire Marshal.
* All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building
Official may grant a one time extention of 180 days, upon the receipt of a written extension request prior to permit expiration.
Letter must indicating that circumstances beyond the control of the permit holder preventing action from being taken. No
more than one extension may be granted.
* Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance
with Mason County Title 14.28 and 14.17.
* If any signs added must comply with MCC 17.34
1 hereby certify that I have read and examined this application and know the same to be true and correct.
All provisions of Laws and Ordinances governing this type of work will be complied with whether
specified herein or not. The granting of a permit does not presume to give authority to violate or cancel
the provisions of any other state/local law regulating construction or the performance of construction.
Issued By:
Contractor or Authorized Agent: Date:
Printed by:Corey Bennett on:06/15/2021 03:55 PM
Page 2 of 2
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Mason County
Mason County - Division of Community Development
615 W.Alder St. Bldg.8
Shelton, WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
F
1-00043 CHANGEINTENANT
ESCRIPTION: OPEN A HAIR SALON IN A SPACE THAT ISSUED: 06/02/2021
OUSLY A HAIR SALON
ESS: 11 NE OLD BELFAIR HWY UNIT B BELFAIR EXPIRES: 11/29/2021
PARCEL: 123294200010
APPLICANT: Petrich, Kara OWNER: ADIO I LLC
2790 NE Old Belfair Hwy PO BOX 370
BELFAIR,WA 98528 BELFAIR,WA98528
3602869525
FEES: Paid Due
Change in Tenant Application $156.00 $0.00
Planning Review Fee $240.00 $0.00
Technology Surcharge $3.12 $0.00
Change in Tenant- Minor EH $120.00 $0.00
Plan Review
State Fee-Commercial $25.00 $0.00
IFC Plan Check Fee $78.00 $0.00
Totals : $622.12 $0.00
REQUIRED INSPECTIONS
BLD-Final Inspection
CONDITIONS
Printed by:Kate Campbell on:06/02/2021 01:49 PM
Page 1 of 2
i
' Mason County
Mason County - Division of Community Development
615 W. Alder St. Bldg.8
Shelton, WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
CHANGE IN TENANT COM2021-00043
OWNER/BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit
revocation.Acknowledgement of such is by signature below. I declare that I am the owner, owners legal representative, or
contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained
permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The
owner or authorized agent represents that the information provided is accurate and grants employees of Mason County
access to the above described property and structure(s)for review and inspection. This permit/application becomes null &
void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of
180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT
APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
* If construction or remodeling is proposed an additional Building Permit and construction documents/drawings may be
required.
* Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries,
Contractor Compliance Division. There are potential risks and monetary liabilities to the homeowner for using an
unregistered contractor. Further information can be obtained at 1-800-647-0982. The person signing this condition is either
the homeowner, agent for the owner or a registered contractor according to WA state law.
* Lever hardware is required at doors. The unlatching of any door shall not require more than ONE operation. Hardware with
locks must open with a single action from the egress side of the door. Door hardware shall allow egress doors to be readily
open able from the egress side without the use of a key or special knowledge or effort. Handles, pulls, latches, locks and
other operable parts on accessible doors shall have a shape that is easy to grasp with one hand and does not require tight-
grasping, pinching, or twisting of the wrist to operate. X
* All building permits shall have a final inspection performed and approved by Mason County Building Department prior to
permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property
records on file with Mason County as being non-compliant with Mason County ordinances and building regulations.
* The use, handling and storage of hazardous materials or flammable and combustible liquids in excess of 10 gallons is not
allowed without the approval of the Mason County Fire Marshal.
* All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building
Official may grant a one time extention of 180 days, upon the receipt of a written extension request prior to permit expiration.
Letter must indicating that circumstances beyond the control of the permit holder preventing action from being taken. No
more than one extension may be granted.
* Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance
with Mason County Title 14.28 and 14.17.
* If any signs added must comply with MCC 17.34
1 hereby certify that I have read and examined this application and know the same to be true and correct.
All provisions of Laws and Ordinances governing this type of work will be complied with whether
specified herein or not.The granting of a p t does not presume to give authority to violate or cancel
the provis'on f"any ther state/ ocal la r ulating construction or the performance of construction.
Issued By:
Contractor or Authorized Agent: Date: lx 2 ZI
Printed by:Kate Campbell on:06/02/2021 01:49 PM
Page 2 of 2
MASON COUNTY 615 W.Alder St.Bldg 8,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 352
COMMUNITY SERVICES BELFAIR:360-275-4467,EXT 352
Building,Planning,Environmentalll alth,Comrnunityll alth ELMA:360-482-5269,EXT 352
www.co.mason.wa.us
INSPECTION CARD AND CERTIFICATE OF OCCUPANCY**
To schedule an inspection call or visit http://www.co.mason.wa.us/community-services/bld-inspection.php
Permit Number COM2021-00043 Date Issued 06/02/2021 Issued j
Project Open a hair salon in a space that was previously a hair salon Lx `
Site Address 11 NE OLD BELFAIR HWY UNIT B
Applicant Petrich,Kara
Contractor
Contractor Phone
Primary Code UPC IBC,IRC,IFC,IEC,IMC,& Type
Permit Type CHANGE IN TENANT Occupancy
-APPROVED PLANS MUST BE ONSITE FOR ALL INSPECTIONS.
-DO NOT PROCEED BEYOND EACH STAGE OR COVER WORK UNTIL APPROVAL IS GRANTED.
-THIS CARD MUST BE POSTED IN A CONSPICUOUS LOCATION,FRONT OF THE PREMISES IS BEST FOR MAKING ENTRY.
-ALL PERMITS EXPIRE 180 DAYS AFTER THE PERMIT IS ISSUED OR 180 DAYS AFTER DATE OF LAST INSPECTION.
-OWNER/AGENT IS RESPONSIBLE FOR REQUESTING ALL INSPECTIONS THROUGH FINAL INSPECTION.
**THIS STRUCTURE MAY NOT BE USED OR OCCUPIED UNTIL ALL APPROVALS ARE GRANTED.**
PRIOR TO CALLING FOR FINAL INSPECTION,ALL CONDITIONS OF THE PERMIT MUST BE MET
Public Works Access/Driveway Other
Health Septic Well
Deptartment
Planning Site Inspection
Department
Fire Marshall Fire Apparatus Access Fire Sprinkler
Auto Fire Alarm Hood and Duct
Other Final
Building
Department Building Official: Community Services Designee
Concrete Setbacks Slab
Footing Perimeter Point load Footing
Footing Interior Footing Decks/Porches
Foundation Stem Walls Other
Rough-In Groundwork Plumbing Framing
Groundwork Mechanical Plumbing
Groundwork Gas Pipe Mechanical
Gas Piping Shear Wall Nailing
Underfloor
Other
Insulation Slab Ceiling
Floor Vaulted Ceiling
Walls Vapor Barrier
Other
Wallboard Interior Wall Brace Panels Fire Walls
Nailing
Other
Final Building I04110
Manufactured Setbacks Setup
Home
Concrete Foot/Runners Final
Other
MASON COUNTY _. (360) 427-9670 Shelton ext.352
DEPARTMENT OF COMMUNITY SERVICES (360) 275-4467 Belfair ext. 352
BUILDING• PLANNING• FIRE MARSHAL g (360) 482-5269 Elma ext. 352
Mason County Bldg. 8 RE E l�� E D
>> 615 W. Alder Street, Shelton, WA 98584 RAtPA ,,. D www.co.masonma.us
F
615'%4 A Ar29 et COM_G�D
CHANGE IN TENANTIA PIMATIO1
PROPERTY INFORMATION
Date: • a-I Assessor's Parcel Number: 3� I
Legal Description:
Building Site Address: I _e Pa i I4u '6 "'I CGt(�_
APPLICANT INFORMATION
Name of Applicant: Li.-
Mailing address: t1 9Z3 Fj F` C)Ic� 1ReS �►� ja u
City: t co r State:W�-q Zip: q
Day phone `ic�a5 Contact Person: y c,;,r�? tf k L y, Message phone:
PROJECT INFORMATION
Proposed business name: Sc'Ac
Proposed use: i\C, v- '�S wicv� Number of employees: i
Previous business name: CE4 -, e "0? Describe previous use:
STRUCTURE DETAILS
Check one: O Detached single level/ single tenant V Single level/ multi tenant
O Multi level/ single tenant O Multi level/multi tenant
Age of structure: Is structure currently If not occupied, how long has it been vacant?
occupied? l : No Yr. Mo.
Square Basement: First: Mezzanine: Second: Third:
footage: I I Gjclo Is
Is the structure Type of Heat: Circle one: Furnace eat Purr ectric walk Radiant
heated?
Circle one: es No Fuel type: Circle one: le�c, Liquid Propane Natural Gas Oil
Will there be any changes to the fol owing?—Circle yes or no, if applicable
Floor lay-out: Yes N ' Lighting: Yes N Heating: Yes Q
Exterior Finishes: Yes N 9 Interior Finishes: Yes No Parking: Yes CNo
Number of restrooms provided: Number of fixtures in each:
I Water Closets Lavatories Bath/Shower
Is structure handicap accessible? Entry: Ye� No Restroom(s): ej No
Is the structure equipped with a fire sprinkler system? Yes N� Fire alarm system? Ye" No
Monitoring Station Name: Phone number:
APPLICATION WILL NOT BE ACCEPTED WITHOUT:
Floor Plan(5 sets):
• Draw the floor plan to scale • Use of rooms
• Room Dimensions • Location of all exits and windows (include dimensions,
• Location of plumbing and mechanical fixtures counters, tables, shelving, benches, fire exits
• Interior doors with swing radius and exit signs).
Site Plan (9): Note scale used
• Property lines, easements, & right of ways • Location of all existing structures & dimensions
• Distance, in feet, from property line & structures • Location of all existing structures & dimensions
• On-site sewage tanks and drain fields, & reserve • Landscape buffer yards
• Location of fire hydrants & vehicle access roads • Well location
• Parking areas (number& arrangement)
Continued on back
i
If construction or remodeling is proposed an additional Building Permit and construction
documents/drawings may be required. /-�
After permit issuance and compliance to all conditions is JWkCEI iED
schedule an inspection by calling
360.427.9670 ext. 352 MAY 2 4 gn2l
OWNER / BUILDER acknowledges submission of inaccurate information may resuu I inVst80iWM,'order or
permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner, owners legal
representative, or contractor. I further declare that I am entitled to receive this permit and to do the work as
proposed. I have obtained permission from all the necessary parties, including any easement holder or parties
of interest regarding this project. The owner or authorized agent represents that the information provided is
accurate and grants employees of Mason County access to the above described property and structure(s) for
review and inspection. This permit/application becomes null & void if work or authorized construction is not
commenced within 180 days or if construction work is suspended for a period of 180 days.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT
APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
Signature of Applicant Date
X k-cuv 0':P-L+V C,u-1 Owner/Owners Representative/Contractor
Print Name (circle to indicate which one)
Official Use Only
Accepted by Date Submittal Amount $ Receipt number
Department Review Initials Date Comments
Building
Fire Marshal
Planning
Occupancy Change? (circle one) Yes No Land Use Designation:
Occupancy classification change from to New occupant load calculated: persons
Existing occupant load design persons. Type of construction
4
COL, MASON COUNTY (360)427-9670 Shelton ext.352
DEPARTMENT OF COMMUNITY SERVICES (360)275-4467 Belfair ext. 352
SUILDING•PLANNING.FIRE MARSHAL (360)482-5269 Elma ext. 352
Mason County Bldg. 8
/XSJ 615 W. Alder Street, Shelton,WA 98584 , 4 � �I www.co.mason.wa.us
615 W. Alder Street COM 30 21 4'j
CHANGE IN TENA1Qr0AftA M6N
PROPERTY INFORMATION
Date: -D ) Assessor's Parcel Number: 3 d 1
Legal Description:
Building Site Address: 11 NE Old fPa i 1-I w 'B - l-fe i- 49 5
APPLICANT INFORMATION
Name of Applicant: a:yev F I may,
Mailing address: i j 9Z -f= t V jAA�u /-,3
City: State:Vi{q ZiML(Q gEr5VA'OKSD
Day phone'-koDP-Bt295_S Contact Person: Kckvc j p,p „'L_b I Message hone: FROM THE F
PROJECT INFORMATION PROJECTION OF 1 i ' G
Proposed business name: ��shceo
Proposed use: �\c �v o Number of employees: I
Previous business name: CLyE h cQ Describe previous use: Sc�So c1
STRUCTURE DETAILS
Check one: O Detached single level/single tenant ® Single level/ multi tenant
O Multi level/sin le tenant O Multi level/multi tenant
Age of structure: Is structure currently If not occupied, how long has it been vacant?
occupied? a No Yr. Mo.
Square __TBasement: First: Mezzanine: Second: Third:
footage: I I cb0c) 8�1_
Is the structure Type of Heat: Circle one: Furnace eat Pu Ej�e Radiant
heated?
Circle one: es No Fuel type: Circle one: le�flic Liquid Propane Natural Gas Oil
Will there be any changes to the fol owing? ircle yes or no, if applicable
Floor lay-out: Yes Co Lighting: Yes Heating: Yes
Exterior Finishes: Yes N Interior Finishes: Yes No Parking: Yes rN2
Number of restrooms provided: Number of fixtures in each:
1 Water Closets Lavatories Bath/Shower
Is structure handicap accessible? Entry: iYe No Restroom(s): a No
Is the structure equipped with a fire sprinkler system? Yes CN Fire alarm system? G1 No
Monitoring Station Name: I Phone number:
APPLICATION WILL NOT BE ACCEPTED WITHOUT:
Floor Plan(5 sets):
• Draw the floor plan to scale • Use of rooms
• Room Dimensions • Location of all exits and windows (include dimensions,
• Location of plumbing and mechanical fixtures counters, tables, shelving, benches, fire exits
• Interior doors with swing radius and exit signs .
Site Plan(1): Note scale used
• Property lines, easements, & right of ways • Location of all existing structures & dimensions
• Distance, in feet, from property line & structures • Location of all existing structures & dimensions
• On-site sewage tanks and drain fields, & reserve • Landscape buffer yards
• Location of fire hydrants &vehicle access roads • Well location
• Parking areas (number& arrangement)
Continued on back
r
i
If construction or remodeling is proposed an additional Building Permit and construction
documents/drawings may be required.
After permit issuance and compliance to all conditions is co tv9 , EIVED
f
schedule an inspection by calling MAY 2 4 7071
360.427.9670 ext. 352
615 W. Alder Street
OWNER / BUILDER acknowledges submission of inaccurate information may result in a stop work order or
permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner, owners legal
representative, or contractor. I further declare that I am entitled to receive this permit and to do the work as
proposed. I have obtained permission from all the necessary parties, including any easement holder or parties
of interest regarding this project. The owner or authorized agent represents that the information provided is
accurate and grants employees of Mason County access to the above described property and structure(s) for
review and inspection. This permit/application becomes null & void if work or authorized construction is not
commenced within 180 days or if construction work is suspended for a period of 180 days.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT
APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICAT;UNNING
X l&>
Signature of Applicant Date
X E�Lw-v Owner/Owners Representative/Contractor
Print Name (circle to indicate which one)
P L/-i i " .4 j
ALL SETBACKS ARE IV+L _D
Official Use Only 'ROM THE IIRTH4
I ION OF
JG
Accepted by Date Submittal Amount $ Receipt number
Department Review Initials Date Comments
Building
Fire Marshal
Planning2)
Occupancy Change? (circle one) Yes No Land Use Designation:
Occupancy classification change from to New occupant load calculated: persons
Existing occupant load design persons. Type of construction
MASON COUNTY (360) 427-9670 Shelton ext.352
DEPARTMENT OF COMMUNITY SERVICES (360)275-4467 Belfair ext. 352
Y BUILDING•PLANNING•FIRE MARSHAL (360)482-5269 Elma ext. 352
Mason County Bldg. 8Ntb
M5-1 615 W. Alder Street, Shelton, WA 98584 $ 2 www.co.mason.wa.us
�0!�
615 W, Alder Sireet COM 0?0 3A —r)
CHANGE IN TENANfA00ftT
PROPERTY INFORMATION
Date: I Assessor's Parcel Number:
Legal Description:
Building Site Address: I I N E Ofd( ( .ea fiq j 14-W 'I6 I f'Q � GUI �a�
APPLICANT INFORMATION
Name of Applicant: �,km I v a @1wE N V1 R Q N E NAL
Mailing address: 11 q_ �j ff� C)l(� ''v �-
City: ` 42-1 State:W`ti=1 Zip:
Day phone 95a Contact Person: Y,c;rc,_�t-Y ;L Message phone:
PROJECT INFORMATION
Proposed business name: C e Sc�1c
Proposed use: (A GCc Y- S of c v�, Number of employees: I
Previous business name: �, �,� ccc Describe previous use: c3c,3 C 4
STRUCTURE DETAILS
Check one: O Detached single level/ single tenant ® Single level/ multi tenant
O Multi level/ single tenant O Multi level/multi tenant
Age of structure: Is structure currently If not occupied, how long has it been vacant?
occupied? QCe No Yr. Mo.
Square Basement: First: Mezzanine: Second. Third:
footage: I I I cbclo _`
Is the structure Type of Heat: Circle one: Furnace eat P p �ctric walk Radiant
heated?
Circle one: es No Fuel type: Circle one: IeEf�, Liquid Propane Natural Gas Oil
Will there be any changes to the fol owing? ircle yes or no, if applicable
Floor lay-out: Yes N Lighting: Yes Heating: Yes
lo'
Exterior Finishes: Yes N,3 Interior Finishes: Yes No Parkin : Yes Na
Number of restrooms provided: Number of fixtures in each:
( Water Closets Lavatories Bath/Shower
Is structure handicap accessible? Entry: Y No Restroom(s): � No
Is the structure equipped with a fire sprinkler system? Yes N Fire alarm system? (Y:ji No
Monitoring Station Name: Phone number:
APPLICATION WILL NOT BE ACCEPTED WITHOUT:
Floor Plan (5 sets):
• Draw the floor plan to scale • Use of rooms
• Room Dimensions • Location of all exits and windows (include dimensions,
• Location of plumbing and mechanical fixtures counters, tables, shelving, benches, fire exits
• Interior doors with swing radius and exit signs).
Site Plan (1): Note scale used �
• Property lines, easements, & right of ways • Location of all existing struc Pres &R, nQsVnE D
• Distance, in feet, from property line & structures • Location of all existing structures4Asr sff
• On-site sewage tanks and drain fields, & reserve • Landscape buffer yard �u[
• Location of fire hydrants &vehicle access roads • Well location
ASON COUNTY ENVIRONMENTAL HEALTH
• Parking areas (number& arrangement) RET
Continued on back
If construction or remodeling is proposed an additional Building Permit and construction
documents/drawings may be required.
After permit issuance and compliance to all conditions is comRECE1 VED
plete
schedule an inspection by calling MM i 2 4 7Q�'
360.427.9670 ext. 352
615 W. Alder Str
OWNER/ BUILDER acknowledges submission of inaccurate information may result in a stop work orc�egtOr
permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner, owners legal
representative, or contractor. I further declare that I am entitled to receive this permit and to do the work as
proposed. I have obtained permission from all the necessary parties, including any easement holder or parties
of interest regarding this project. The owner or authorized agent represents that the information provided is
accurate and grants employees of Mason County access to the above described property and structure(s) for
review and inspection. This permit/application becomes null & void if work or authorized construction is not
commenced within 180 days or if construction work is suspended for a period of 180 days.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PER IT
APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLKEANWRON N - I L
H EALTH
x
Signature of Applicant Da e--T
X Iwo " i L,� Owner/Owners Representative/Contractor
Print Name (circle to indicate which one)
Official Use Only
Accepted by Date Submittal Amount$ Receipt number
Department Review Initials Date Comments
Building
Fire Marshal LJAV
Planning MA ON COUNTY ENVIROtiYENTAL HEALTH
RET
Occupancy Change? (circle one) Yes No Land Use Designation:
Occupancy classification change from to New occupant load calculated: persons
Existing occupant load design persons. Type of construction
}-}: 0n- r rreA z7(Z f
&I \CAr\-�� Tr\ 4C/�. PO-
S rQ.� �u ✓ a-daq `- (-ev
.ors �'oo
MASON COUNTY (360) 427-9670 Shelton ext.352
DEPARTMENT OF COMMUNITY SERVICES (360) 275-4467 Belfair ext. 352
BUILDING•PLANNING.FIRE MARSHAL e (360) 482-5269 Elma ext. 352
Mason County Bldg. 8 �l m
615 W. Alder Street, Shelton, WA 98584 MAY 2 4 '?0Ct www.co.mason.wa.us
619 5 W. lder Sheet COM a0 a l h_�(Z4
CHANGE IN TENAh&XWAfNV1M
PROPERTY INFORMATION
Date: Assessor's Parcel Number:
Legal Description:
Building Site Address: f Ct i`l; J9 �a
APPLICANT INFORMATION
Name of Applicant: CJ'N
Mailing address: C)1c� e1-{,mil V Vv�_u\-
City: 1 �.���r State: �� Zip: ,
Day phone� 0-�4,'f5aS Contact Person: Kc rc�?�t v i��� Message phone:
PROJECT INFORMATION
Proposed business Sc Ac
Proposed use: Number of employees:
Previous business name: C, - ccZ Describe previous use: c3C, p 4
STRUCTURE DETAILS
Check one: O Detached single level/single tenant ® Single level/ multi tenant
O Multi level/ single tenant O Multi level/multi tenant
Age of structure: Is structure currently If not occupied, how long has it been vacant?
occupied? a No Yr. Mo.
Square Basement: First: Mezzanine: Second: Third:
footage: I I I CjC)D
Is the structure Type of Heat: Circle one: Furnace eat Purim ectric wk Radiant
heated?
Circle one: es No Fuel type: Circle one: Iecftc, Liquid Propane Natural Gas Oil
Will there be any changes to the fol owing?c e ircle yes or no, if applicable
Floor lay-out: Yes N Lighting: Yes Heating: Yes
Exterior Finishes: Yes QN Interior Finishes: Yes No Parkin : Yes Nq
Number of restrooms provided: Number of fixtures in each:
( Water Closets Lavatories Bath/Shower
Is structure handicap accessible? Entry: Ye No Restroom(s): No
Is the structure equipped with a fire sprinkler system? Yes CN Fire alarm system? Ye' No
Monitoring Station Name: I Phone number:
APPLICATION WILL NOT BE ACCEPTED WITHOUT:
Floor Plan (5 sets):
• Draw the floor plan to scale • Use of rooms
• Room Dimensions • Location of all exits and windows (include dimensions,
• Location of plumbing and mechanical fixtures counters, tables, shelving, benches, fire exits
• Interior doors with swing radius and exit signs).
Site Plan (1): Note scale used
• Property lines, easements, & right of ways • Location of all existing structures & dimensions
• Distance, in feet, from property line & structures • Location of all existing structures & dimensions
• On-site sewage tanks and drain fields, & reserve • Landscape buffer yards
• Location of fire hydrants & vehicle access roads • Well location
• Parking areas (number & arrangement)
Continued on back
N
If construction or remodeling is proposed an additional Building Permit and construction
documents/drawings may be required. RECEIVED
EIOiEp
After permit issuance and compliance to all conditions is comp)-6-
schedule an inspection by calling 2 4 2n2l
360.427.9670 ext. 352 615 W.
Alder Scree}t
OWNER / BUILDER acknowledges submission of inaccurate information may result in a stop work order car
permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner, owners legal
representative, or contractor. I further declare that I am entitled to receive this permit and to do the work as
proposed. I have obtained permission from all the necessary parties, including any easement holder or parties
of interest regarding this project. The owner or authorized agent represents that the information provided is
accurate and grants employees of Mason County access to the above described property and structu e for
review and inspection. This permit/application becomes null & void if work or authorized construc �iohot
commenced within 180 days or if construction work is suspended for a period of 180 days. MARSH
AL
PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT
APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
Signature of Applicant Date
X Owner/Owners Representative/Contractor
Print Name (circle to indicate which one)
Official Use Only
Accepted by Date Submittal Amount$ Receipt number
Department Review Initials Date Comments
Buildin
Fire Marshal
Planning
Occupancy Change? (circle one) Yes No Land Use Designation:
Occupancy classification change from to New occupant load calculated: persons
Existing occupant load design persons. Type of construction
13.8' � ']� y
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Soulstiee Salon Tree Tree
11.2 O Chair Chair '.. 5.2' a -
11 NE Old Belfair Hwy
Belfair WA
Table Exit
98528 34"
4.2'
1 L6'
Chair&
Floor Mat
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Building Storage Tattoo Shop
Chair& Not part of lease
Floor Mat
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16.5 Chair& 3.3' G
p Floor Mat
Storage
15 \N. Alder Str
36"
ca
36" 8 2
Exit
Single Step Cabinet
6.10' Restroom 6W
36" Shampoo Bowl
Sink
10.2' Storage Storage 7.8'
36
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36" 7 8"
I
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36" Coffee stand
17.6
Office I
uQsk
36" ---
Exit
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Hot Water Heater
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RECEIVED
MAY - 6 2021
615 W• Alder Street
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